Demos highlights importance of talking to patients
Pharmacists expected to fill in
the blanks left by GPs
The nature of conversations that pharmacists have
with their patients was also considered in the Demos report.
Pharmacists
who contributed told researchers that their conversational role
with patients is in flux.
They said the profession is increasingly
expected to fill in the blanks after patients have consulted
their GP.
The report says: “The power relationship is less well established
than with a doctor so conversations [with a pharmacist] can be more exploratory. …Where
once they would be the source of information about medicines, pharmacists
are now increasingly arbiters of conversation with an informed public.”
The conversations the profession has with patients, especially
on hospital wards, is today “more open and honest than those that people feel
they should be having with doctors”, says the report. |
Concordance, rather than compliance, should underpin conversations pharmacists have with patients about their medicines, a report
published this week by the think tank Demos recommends.
Access to information on the internet makes patients more informed about
their medicines and, coupled with the Government’s choice agenda,
patients increasingly expect to negotiate decisions about their medicines,
says the report called “The talking cure: why conversation is the
future of healthcare”.
But replacing “compliance” with “concordance” in
the NHS vocabulary has little to do with political correctness and requires
a “fundamental rethink” about the health professional and
patient relationship, the document points out.
“Concordance involves recognising patients’ expertise rather
than just finding medicines to fit their chaotic lives,” the report
says. “It asks professionals to agree goals with patients rather
than assume them. It asks that the role of the patient in decisions and
ongoing care is brought to the fore.”
Concordance also creates an opportunity to give the debate around choice
more force because it suggests that patients should be intimately involved
in choosing the things that matter to them — such as treatment
and care plans — and rejecting the things that they think are less
important, the report says.
If concordance is allowed to rise to the top of the medicines agenda
it would have a profound effect on the development of health services
and new medicines, Demos suggests.
The focus, Demos says, would change from one that concentrated on developing
ever more powerful drugs to one, which is already emerging, centred on
improving patient information and patient decision aids.
Demos refers to an editorial in the BMJ (11 October 2003), which
said that “concordance doesn’t come easy” but adds: “Given
that compliance, coercion and other approaches have routinely failed,
it is worth working out how to make concordance work.”
The report’s author Jack Stilgoe said at its launch: “Patients
are becoming experts too and the NHS needs to acknowledge this and listen
to them. As Lord Darzi puts the finishing touches to his review on the
future of the NHS the focus should be less about the mechanics of the
system and more about the people who are at the heart of healthcare.”
Among its recommendations Demos suggests that GPs and patients with chronic
conditions should establish “outcome statements” that spell
out shared goals; patients with long-term conditions should be given
personal budgets to design their own package of healthcare.
They should
also be given patient packs detailing what they can expect from consultations,
what their rights are and what kind of questions to ask healthcare professionals
to ensure they get the most out of their care.
The think tank also calls on the Government to create what it calls “Wikirecords” — online
accessible patient records that patients can contribute to and comment
on.
|
The
Pharmaceutical Journal
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